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Idiopathic Environmental Intolerance: A Comprehensive Model
Open accessAbstract
Idiopathic environmental intolerance refers to a group of poorly understood health conditions characterized by heterogeneous somatic symptoms that occur in response to environmental triggers, but for which no physiological causes can be found. We focus on three varieties, namely symptoms attributed to (a) chemical substances, (b) electromagnetic fields, and (c) infrasound and vibroacoustic sources. As no clear link with organ pathology or dysfunction has been established so far, we review critical evidence about alternative causal mechanisms as a platform for a novel unifying model of these conditions. There is consistent evidence that expectancy and nocebo mechanisms are critically involved. Using recent predictive coding models of brain functioning, we describe a comprehensive new model to explain how symptoms come about and become linked to specific environmental cues. This new model integrates phenomenally different pathologies, suggests testable new hypotheses, and specifies implications for treatment.
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“Research has revealed that disabling PPS, manifesting as building-related environmental intolerance, has a biopsychosocial nature, emphasizing symptom perception, awareness, and interpretation rather than organic or toxicological causes [12, 13, 15].”
From Work Ability and Functioning Among Individuals with Persistent Indoor Environment-Related Symptoms or Chronic Fatigue: Nine-Month Follow-Up of a Web-Based Randomized Controlled Trial. (2026) · cites this paper as [12]
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“Excessive central nervous system reactivity and related illness worry (IW) may be seen as core features of PPS and they often overlap [12, 16].”
From Work Ability and Functioning Among Individuals with Persistent Indoor Environment-Related Symptoms or Chronic Fatigue: Nine-Month Follow-Up of a Web-Based Randomized Controlled Trial. (2026) · cites this paper as [12]
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Metadata
- Authors
- Van den Bergh, O., Brown, R. J., Petersen, S., & Witthöft, M.
- Affiliations
- Health Psychology, University of Leuven, Belgium
- Greater Manchester Mental Health NHS Foundation Trust (GB)
- University of Luxembourg (LU)
- Johannes Gutenberg University Mainz (DE)
- Venue
- Clinical Psychological Science
- Publisher
- SAGE Publications
- Published
- 2017-05
- Volume
- 5
- Issue
- 3
- Pages
- 551-567
- ISSN
- 2167-7026 (ISSN-L)
- 2167-7034
- OpenAlex
- W2593754217
- Cited by
- 121
- References
- 127
- Citations by year
- 2026: 7 · 2025: 10 · 2024: 11 · 2023: 6 · 2022: 11 · 2021: 8 · 2020: 47 · 2019: 8 · 2018: 6 · 2017: 7
- FWCI
- 15.35
- Type
- journal article
- Language
- en
- Open access
- green
- orbilu.uni.lu
- Locations
- Clinical Psychological Science (publishedVersion)
- Open Repository and Bibliography (University of Luxembourg) (submittedVersion, other-oa)
- Research Explorer (The University of Manchester) (submittedVersion, other-oa)
- Lirias (submittedVersion)
- Funders
- Fonds National de la Recherche Luxembourg
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
- Physical Sciences › Physics and Astronomy › Acoustics and Ultrasonics › Noise Effects and Management
- Keywords
- multiple chemical sensitivity, electromagnetic hypersensitivity, infrasound, somatic symptoms, environmental triggers, expectancy, nocebo, predictive coding, causal mechanisms, therapeutic implications
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